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Best test for hyperthyroidism
Which is better for follow up for hyperthyroidism? Is it TSH or FT4. I have Graves’ disease for over 10 years and am currently on carbimazole 5 mg and Propranalol 5 mg once a day. Recent reports show TSH < 0.01 and FT4 as 21.1 ( normal range 9-21).
Doctors have been taught that TSH is basically the only test needed to determine a patient's thyroid status. This is expedient but it is false. In reality TSH has only a weak correlation with the acttual thyroid hormones, and a negligible correlation with patient symptoms. So TSH is useful as a diagnostic only when it is at extreme levels. TSH should not be used to determine a patient's medication dosage.
A thyroid patient's should be treated as needed to relieve symptoms, guided by levels of Free T3 and Free T4. Free T3 is the biologically active thyroid hormone that largely regulates metabolism. Free T4 is a prohormone available for conversion to FT3.
Your FT4 is at the top of the range, suggesting that perhaps you are still somewhat hyper. You really need to also test for FT3. More importantly please tell us about any symptoms you have currently.
A thyroid patient's should be treated as needed to relieve symptoms, guided by levels of Free T3 and Free T4. Free T3 is the biologically active thyroid hormone that largely regulates metabolism. Free T4 is a prohormone available for conversion to FT3.
Your FT4 is at the top of the range, suggesting that perhaps you are still somewhat hyper. You really need to also test for FT3. More importantly please tell us about any symptoms you have currently.
1 Comments
Hi ..many thanks..I don’t have any major symptoms except some digestive issues..so am wondering if I need to increase my dose.
Not sure why he increased Propranolol and not Carbimazole. I hope the Endo corrects that.
3 Comments
Finally the Endo has put me on 10 mg carbimazole and 10 mg propranalol. So that should be ok, I guess.
Much better. Please let us know how it works for you.
Feeling much better . By the time the Endocrinologist’s reply came, I think my FT4 had increased even more. Next blood test is scheduled in August.
I suggest that you talk to your doctor about your symptoms and your FT4 being at top of range, and ask if you need to increase your carbimazole dose a bit. I also suggest that you should make sure they also test for Free T3 whenever labs are done. Please let us know how it goes.
3 Comments
Yes.. I will consult my doctor. Thanks .. will keep u posted
I spoke to my GP ..he has advised to increase propranolol to 20 mg and he said he will consult an Endocrinologist and get back to me.
He said that the FT4 is just borderline and symptoms can be controlled by propranalol. Let’s see what the endocrinologist says. Will keep u posted..thanks
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